Governing through lifestyle—Lalonde and the biopolitical management of public health in Canada

Abstract

In 1974, the Liberal government of Pierre Trudeau released a "green paper" known as the Lalonde Report, after the health minister at that time. The report formulated perspectives on health and the main concepts and ideas developed in it, particularly the concept of "lifestyle," which became the foundation of public health policies in many different European countries and the United States. The concept of "lifestyle" connected personal behaviour and habits to the individual health condition; people were not dying due to a lack of access to medical care but because they lived a life prone to personal risk taking. Furthermore, what is seldom discussed is that this report not only propagated the (neo)liberal view of citizens as autonomous rational actors (homo oeconomicus), with personal responsibility for their health, but it was a first step in the transformation of Medicare and went far beyond the question of health promotion. Health was no longer something that happened to a person but was created through personal choice and, therefore, one had to assume responsibility for one's behaviour. Using Foucault's definition of government as the "conduct of conduct," we will demonstrate that the Lalonde report must be understood as a specific "technology of government" and contributed to a neoliberal transformation of health care despite the fact that the Canadian system of Medicare was based on the idea of universality, meaning citizens had equal access to health care independent of their socio-economic situation. As we will demonstrate, the Lalonde report undermined this foundation and initiated a profound reorientation, not only of the healthcare system, but even more importantly, it radically changed the way we think about our behaviour around health-related issues. We will also discuss how the making of the report contributed to the redefinition of politics and demonstrated a lack of concern with liberal-democratic decision-making processes.

Understanding culturally safe cancer survivorship care with inuit in an urban community

“…Most studies to date have taken an illness-based empiric approach, comparing quantitative metrics related to Inuit cancer survivorship with similar metrics for non-Inuit (or non-Indigenous) populations such as rates of cancer [ 48 ], “potential years lost” [ 49 ], comorbidities [ 50 ], and “risk factors” [ 51 ]. Other studies have explored reasons Inuit patients do not comply with cancer screening recommendations and treatments [ 52 ], emphasising Western conceptions of one’s personal responsibility for their health [ 53 ]. There is no doubt a need to provide biomedically-based curative treatments and care, and while this is certainly valuable knowledge, it does little to actually address or engage with the social determinants of Inuit health [ 54 ].…”

Health Promotion Practices and Michel Foucault: A Scoping Review

“…25 Nine studies were developed in Europe: 4 in the United Kingdom, 26 -29 2 in Denmark, 30,31 2 in Sweden, 32,33 and 1 in Belgium. 34 Five studies were developed in North America: 4 in Canada 35 -38 and 1 in the United States. 39 Three studies were developed in Oceania, all in Australia.…”

“…The articles addressed the following HP practices: 13 addressed governmental and international organization HP policies and programs; 12,15,18,21 -24,26,30,32,33,37,39 8 addressed health education, medication adherence and change of habits carried out in individual appointments; 16,19,20,27,29,31,34,40 one addressed aging and physical activity 11 ; one addressed healthy eating and physical activity 36 ; 3 addressed health education campaigns for the prevention of infectious diseases with a behavioral approach 25,38,44 ; one addressed HP in the work environment 28 ; one addressed HP in the school space 43 ; one addressed traffic behavior and alcohol consumption while driving. 17…”

Risk Factors of Metabolic Syndrome among Polish Nurses

“…The issue of appropriate health behaviors and self-care is increasingly being taken up by scientific communities around the world [ 1 , 2 , 3 ]. Scientists emphasize the importance of the adopted attitude toward health and the resulting behaviors, such as regular weight control, following dietary recommendations, regular physical activity and participation in preventive examinations [ 4 , 5 , 6 , 7 , 8 ]. Metabolic syndrome is a complex of interrelated risk factors for the development of cardiovascular disease (CVD) and diabetes.…”